Magnetically driven crossing tools for arterial and venous occlusions

Abstract

A guidewire insertion device ( 10 ) includes a first guidewire ( 12 ) including an electromagnetic tip ( 14 ); a second guidewire ( 16 ) including a magnetic tip ( 18 ); and a controller ( 33 ) configured to modulate a force of the electromagnetic tip of the first guidewire to control movement of the magnetic tip of the second guidewire.

1 . A guidewire insertion device, comprising:
 a first guidewire including an electromagnetic tip;   a second guidewire including a magnetic tip; and   a controller configured to modulate a force of the electromagnetic tip of the first guidewire to control movement of the magnetic tip of the second guidewire.   
     
     
         2 . The guidewire insertion device of  claim 1 , wherein the controller configured to modulate the force of the electromagnetic tip of the first guidewire between an attractive force and a repulsive force to control movement of the magnetic tip of the second guidewire. 
     
     
         3 . The guidewire insertion device of  claim 1 , wherein the magnetic tip of the second guidewire comprises one of an electromagnet, a permanent magnet, or a ferromagnetic element. 
     
     
         4 . The guidewire insertion device of  claim 1 , wherein the electromagnetic tip of the first guidewire includes at least three electromagnets spaced apart radially around a central axis of the first guidewire. 
     
     
         5 . The guidewire insertion device of  claim 4 , wherein the controller is configured to independently modulate the force applied by each respective electromagnet to steer the movement of the magnetic tip of the second guidewire. 
     
     
         6 . The guidewire insertion device of  claim 1 , wherein the first guidewire further includes an expandable member disposed around the electromagnetic tip and configured to align the electromagnetic tip with the magnetic tip of the second guidewire. 
     
     
         7 . The guidewire insertion device of  claim 6 , wherein the expandable member is a self-expanding member, and the first guidewire further includes a deployment sheath configured to release the self-expanding member. 
     
     
         8 . The guidewire insertion device of  claim 6 , wherein the expandable member comprises nitinol. 
     
     
         9 . The guidewire insertion device of  claim 6 , wherein the expandable member includes a plurality of ferromagnetic elements that are magnetized by the electromagnetic tip of the first guidewire to cause the ferromagnetic elements to mutually repel to expand the expandable member. 
     
     
         10 . The guidewire insertion device of  claim 1 , further including one or more radiopaque markers attached to the first guidewire and to the second guidewire. 
     
     
         11 . A guidewire insertion method performed using the guidewire insertion device of  claim 1 , the method comprising:
 disposing the first guidewire on a first side of an occlusion in a target tissue;   disposing the second guidewire on a second, opposing side of the occlusion; and   operating the controller to modulate the force of the electromagnetic tip of the first guidewire to control movement of the magnetic tip of the second guidewire.   
     
     
         12 . The guidewire insertion method of claim  12 , wherein the operating includes:
 operating the controller to selectively draw the magnetic tip of the second guidewire toward the electromagnetic tip of the first guidewire.   
     
     
         13 . The guidewire insertion method of  claim 12 , wherein the operating includes:
 operating the controller to cycle the force of the electromagnetic tip of the first guidewire between a repulsive force and an attractive force to drive a reciprocating motion of the magnetic tip of the second guidewire.   
     
     
         14 . A guidewire insertion device, comprising:
 a guidewire including a ferromagnetic element disposed on or in a tip of the guidewire and an electromagnet disposed on or in the tip of the guidewire; and   a controller configured to modulate electric power applied to the electromagnet to produce reciprocating movement of the tip of the guidewire driven by magnetic interaction between the electromagnet and the ferromagnetic element.   
     
     
         15 . The guidewire insertion device of  claim 14 , wherein:
 at least the tip of the guidewire includes a sheath, and   one of ferromagnetic element or the electromagnet is secured to the sheath, and   the other of the ferromagnetic element or the electromagnet is not secured to the sheath.   
     
     
         16 . The guidewire insertion device of  claim 15 , wherein the ferromagnetic element is a permanent magnet. 
     
     
         17 . The guidewire insertion device of  claim 14 , wherein at least the tip of the guidewire is hollow. 
     
     
         18 . The guidewire insertion device of  claim 17 , further comprising:
 a nonmagnetic shaft disposed inside the hollow tip of the guidewire;   wherein the ferromagnetic element includes first permanent magnet and a second permanent magnet disposed at opposite ends of the nonmagnetic shaft inside the hollow tip of the guidewire.   
     
     
         19 . The guidewire insertion device of  claim 18 , wherein the electromagnet is disposed between the first and second permanent magnets and at least one of the first permanent magnet and a second permanent magnet is secured to the guidewire. 
     
     
         20 . A guidewire insertion device, comprising:
 a sleeve;   a plurality of electromagnets mounted on the sleeve;   a guidewire having a ferromagnetic tip; and   a controller configured to modulate a force of the electromagnets to control movement of the ferromagnetic tip.